Is it OK to not want to live like that?

percy4
percy4 Member Posts: 477


So.  Here I am.  Low chance of recurrence (how low, I don't know).  I have had surgery, have done the rads, and am refusing hormonal therapy.  I have had life-altering hot flashes for 12 years (all through peri, and worse in menopause).  I just can't reason taking an AI, with a low chance of recurrence.  I have been asked whether I would choose to possibly lose a breast in future, or even needing to have chemo, as opposed to the VERY real chance of awful bone and joint pain, real chance of increased osteoperosis, increased hot flashes (I can't), and many other things.  I choose exercise, serious exercise, which has been proven to cut recurrence by 30%, as opposed to cutting recurrence chance by 40-50% (from what my recurrence chance is; perhaps 10%, not 100%) with an AI, the real difference being maybe 3-7 %.  What would you-all do?  I think I have made my decision.  Let me point out that, although I am 57, I have raised my kids.  They are almost 40, as I had them young.  I would like to live out my normal 30+ years, but if I don't, it will still be OK.  Then, again, ask me when and if that decision is gone; I might feel differently  Would I like to feel like an old woman, right now, or would I like to take a small chance and live like me?

Comments

  • Annette47
    Annette47 Member Posts: 957
    edited March 2014

    I think you are fine making the decision that you are.   I know in my case, and I am younger than you (my recurrence rate after rads was supposedly 15%), my MO said that he would be comfortable either way.   I decided to try it with the knowledge that I could stop if the side effects got too bad (being premenopausal I have not had any history of hot flashes, joint problems, etc.).   I have had only minor SE's and plan to continue taking it, but as I said, I went into it from a different place than you.    If you are at all torn, you could try it and see as the "quality of life" SE's as my MO put it go away once you stop the drug - it doesn't have to be 5 years or nothing.

  • lemon68
    lemon68 Member Posts: 684
    edited March 2014

    Hi Percy

    That is a choice only you can make, I have also made the choice not to take tamoxifen or a AI. I feel pressure sometimes on the boards and previously my oncologist but my choice is mine. I am looking into DIM and have gotten a lot of information here on the boards about it. I gave up my ovaries at age 44, instant menopause, I feel for you with the hot flashes its a tough time. I have to live with my choices and if I do have a reoccurrence I will not think its because I didn't take my AI.  Go with your gut or heart and do what you feel is right for you and its okay. Best to you.

  • have2laugh
    have2laugh Member Posts: 132
    edited March 2014

    It is confusing for sure and like you I hope to recommit to working out regularly to decrease risks. I am a little younger and premenopausal so my decision involves Tamoxifen. I meet with medical and radiation oncologists on Monday, one more week postop and will start radiation. I was really more conflicted about Tamoxifen than another other part of treatment plan. I don't know why exactly, maybe my age-just turned 44 and taken aback every time-and there have been a quite a few the last few months- when someone asks, do you still have a period? I know estrogen isn't a friend to my DCIS but I am not ready part ways just yet. The blood clot risk stands out and yet I never gave that a second thought when I was on oral birth control though it is a risk with this medication as well. Two of my sisters took Tamoxifen for IDC, one with no issues-though chemo kicked into menopause, one still on and having some uterine issues but continuing with plan. Every treatment or medication has side effects. As a nurse, the rational side of me can tell you most people have no idea how many side effects are listed on things we think very little about taking either by prescription or over the counter. But as a patient, I don't taking  any medications on a daily basis right now and I was nervous looking at the list of things I could encounter. All the risk calculators aside and with great respect for those making more difficult care decisions, I can certainly understand not wanting to have five years feeling any less than your best. One of my doctors said something that clicked with me. " It is a pill, no one is going to come to your house every day and make you take it". Something about looking at the plan day by day rather than a five year commitment made more sense to me. My plan- I will try for three months, if everything ok will try three more, then 6, etc. I am sure I will leave with my script in hand Monday and at this point I plan to fill it. Will see how it goes but of course I am still nervous. Not sure that helps but just another way of looking at it. Whatever you decide-I wish you well.

  • Rubiayat
    Rubiayat Member Posts: 144
    edited March 2014

    Hi Percy, we are faced with so many difficult decisions on this road! Your last sentence really struck me - would you like to live like you? One thing that has really hit home to me from having breast cancer is just how precious every day is and how unpredictable life can be. How do you want to live the rest of your life? Something tragic could happen tomorrow and dealing with the SE of an Al would be for naught. I have decided not to take Tamoxifen for the same reasons. I am 41 and I don't want to be thrown into menopause (even if not permanently) at this point in my life. My daughter is young and this decision does weigh heavily on me. In the end, the small decrease in my chance of a recurrence is not worth SEs for me. I feel like I have lost enough already (well, about to lose my breast) and, dammit, I'm not giving up my youth too!!

  • keepthefaith
    keepthefaith Member Posts: 2,156
    edited March 2014

    percy, quality of life is definitely an issue while making these decisions. I am torn also, but will probably try HT for a few months to see how I tolerate it. I am 58. Menopause was not too hard on me, but not looking forward to doing it again! I did have the onco test and was in the low/intermediate range at 21. That gave me a 13% risk of recurrence, w/HT for 5 yrs.  I decided on chemo, which hopefully reduced it a bit...part of my decision to do chemo was that if I decided against HT after rads, then at least I had done chemo. My MO told me that if I did not tolerate one of the Hormone therapies well, I could switch to a different one w/o a problem. Have you had a bone density test done? I have osteoporosis and osteopenia, so that is a problem, too. I am taking Vit D and calcium, trying to walk more often. I think it's great that you are excercising to reduce your risk. Good luck with your decision!

  • Solen
    Solen Member Posts: 146
    edited March 2014

    taking the AL only lowers my risk of recurrance by two percent , not worth feeling awful over.  My risk is low already, due to BMX and hysterectomy.  I think this disease go enough of me.  I am doing what you are doing, upping my exercise ( yes, the house is currently a mess,LOL) and eating healthier.  I feel great.  Vs feeling awful on the al.  

    Only thought in the back of my mind is that I was exercising and eating healthy before my first diagnosis.........but I am still putting my eggs in that basket and there is no guarantee either way, so I won't beat myself up if the small chance of recurrance happens.

    All I can say is good luck to all of us!!!!

  • pupmom
    pupmom Member Posts: 5,068
    edited March 2014

    Solen, just curious. Are you DCIS or Stage 1? You list both of those in your dx for 2013. Stage 1 only refers to those who had invasive cancer.

  • have2laugh
    have2laugh Member Posts: 132
    edited March 2014

    Yorkiemom-

      Perhaps this isn't the place to say this and forgive me as I am sure you are coming from a place of concern in helping Solen assess her situation but as a newcomer to any breast cancer site, I have to say I am really surprised how many times others feel they have to define DCIS or point out that it is not invasive, can not metastasize, or even say it's not really breast cancer. With all due to respect those with invasive types of breast cancer and as the sister of two who happily can say they are breast cancer survivors of IDC and the wife of a wonderful man who lost his mother to breast cancer at 43, those of us with DCIS face many of the same tough decisions with probably a little more uncertain treatment plans. No, it will not kill me and certainly that is a big factor. But I do know the fear that comes with a potentially life threatening illness. Though normally very healthy, I had another health crisis three years ago that only effects women. As the mother to a two week old infant I faced a difficult diagnosis and uncertain recovery. For the first  and only other time, I sought out information from an online support site. Women in this group ran the gamete from mildly effected to having had or waiting for heart transplants.  There were no separate sites for "stages", everyone supported each other no matter how easy or difficult their journey, they were there for each other. I can sadly not say I have felt that same support amongst the breast cancer group. I digress as this is really about supporting Solen and I speak only for myself and perhaps am a little sensitive, but I would like to encourage others to consider that the losses physical and emotion that those of with DCIS are no less real or painful than others with invasive types of cancer. It sometimes feels like we go through all this and we don't even get the pink t-shirt? It is a little disheartening. Solen- I apologize for using this forum to vent and will continue to think of you.

  • pupmom
    pupmom Member Posts: 5,068
    edited March 2014

    All I was saying is that DCIS is not Stage 1, it is Stage 0. When people put DCIS, Stage 1 on their diagnosis line it is confusing. My question had nothing to do with the difficulties DCIS people experience. Sorry if you interpreted my statement that way.

  • ziggypop
    ziggypop Member Posts: 1,071
    edited March 2014

    Hi Percy, 

    There are so many differences in people's circumstances that there just can't be a one-size-fits all answer. An oncologist's job (as they see it usually) is to treat the cancer & minimize the risks (they of course balance that with risks from treatment which is why not all women get chemo). So they will generally 'push' according to the numbers. You have to figure in the other stuff. 

    One option for you might be to try tamoxifen, one of its SEs in women who are post menopausal is that it actually increases bone density. I does, for a lot of women, bring on hot flashes. It has for me & I have been able to control them with effexor. Since it's a pill, there is the alternative of just trying it for awhile & weighing the actual side effects that you experience against the benefits. Just an idea. 

    havetolaugh - There are a lot of reasons for people to help define the difference between invasive and non-invasive cancers that do not have anything at all to do with an attempt to diminish or make light of the circumstances that those with DCIS face. The biggest reason is to help newbies understand their treatment options & why the treatments being proposed for them are what they are. It's confusing for them if they see a signature line with DCIS stage 1 in it & it also created confusion when someone with that in their signature line asks a question. I think that if you stick around here, you will find that the women here are very supportive and understanding of one another. We all know that this is scary and hard for all of us and comparisons of 'my cancer is worse than yours, or my cancer is just as bad as yours' are worthless. The division of stages and types is really because there are some things that (for instance) a woman with a triple negative or a her2+ diagnosis can understand that I can't. Other than one forum that is for stage IV members only, you'll see that women with all stages post on other threads, but generally, I'm not going to comment on an IBC thread because I don't really have anything to offer. What I'm trying to say is that we want you her & understand that whatever our diagnosis we all can use some support and information and hugs. (((hugs)))  

  • Solen
    Solen Member Posts: 146
    edited March 2014

    yorkiemom, my profile was not correct and when I tried to fix it, I kept getting a message that the "something went wrong"  LOL, I kind of know that as I wouldn't be here otherwise.  I tried just now to update it, not sure it worked.  sorry if it confused you, I really don't pay attention to stage for my own diagnosis for some reason.  All I know is my chances of recurrence are low, but are still there so I am trying to do all I can naturally to help my chances.

  • have2laugh
    have2laugh Member Posts: 132
    edited March 2014

    Ziggypop-

       I realize the question re staging may have come in attempt to help assess risks and offer help and I eluded to such in my first sentence. I certainly did not mean to detract from anyone's experiences or good intentions but to be honest I have read other entries that did make me feel a little like there is some underlying mine is worse than yours mentality. The last few months have felt a little like pledging a sorority your can't join and don't really want to be.  I am hopeful I may never "leave" this group to join to the IDC group. I actually have a pretty good outlook and sense of humor about all this though it didn't show this time. Perhaps I am just having a moment and just a little tired. In any event I meant no disrespect and appreciate those that do reach out.

  • pupmom
    pupmom Member Posts: 5,068
    edited March 2014

    Solen, it looks like you were able to fix the dx line. It does take awhile to learn how to navigate this site.

    Have2laugh, just for the record, I have no issues about people's stages, whether lower or higher than mine. As far as I'm concerned we're all in this together. It's not a competition or a sorority! In fact this is the club none of us ever wanted to join. I'm sure we would all love to return to the days when we were blissfully ignorant of bc stages, grades, er/pr, her etc. 

    Best wishes!

  • Beesie
    Beesie Member Posts: 12,240
    edited March 2014

    have2laugh, 

    As someone who often asks women about what appears to be inconsistent information on a diagnosis line, I appreciate yorkiemon's question to Solen, and I'm glad that Solen was able to get her diagnosis line corrected.

    The reason I ask the the question when I see inconsistencies is because I have spent years answering questions and trying to explain to women with DCIS that DCIS is always and only Stage 0. I can't tell you how many DCIS women I have had to pull off the ledge, after they have seen a post from someone with a diagnosis line that says "DCIS, Stage IIIa" who is talking about chemo treatments or perhaps a post in the Stage IV forum from someone who started out with "DCIS, Stage IIb". Some women with DCIS are convinced their doctors are wrong when they tell them that chemo isn't prescribed for DCIS because they've seen women on this board who have DCIS and who've had chemo.  And some women with DCIS fear that DCIS can progress to mets - regardless of what their doctors told them - because they have seen quite a number of women on this board who have mets but who started with DCIS. 

    For me, it's not a question of assessing risk or in any way downplaying a diagnosis of DCIS.  My concern is that inaccurate information, even on just a diagnosis line, can lead to confusion and concerns and sometimes even to panic.  I've seen it happen way too many times.

  • have2laugh
    have2laugh Member Posts: 132
    edited March 2014

    Bessie-

     I appreciate your commitment to others as clearly you spent a lot of time helping a great many in your years here. I never doubted anyone's intentions just made an observation. Simply my perspective and feelings at that moment. My comments were not based wholly on things from this site, but from looking at multiple sites to gain insight and from rare comments made by seemingly well intentioned people. I have a great support system and am happy to feel well enough to have just played a little hopscotch with my little one. I am very grateful. I think I will concentrate on radiation, recovery, and enjoying all I have in my life. Good luck to you all.

  • Solen
    Solen Member Posts: 146
    edited March 2014

    thank you, have2laugh!

    Didn't know I could cause so much controversy.  The truth is, my real journey is a bit complicated, but I am fine and happy.  I tend to not like to be dramatic about the whole stinkin thing that is my breast cancer.  Which makes it a bit ironic that my info caused so much trouble.  Like I said I had tried to fix it, and kept getting a message that it couldn't be done.    People cannot always compare themselves to others that are the same stage or diagnosis anyway......too many variables, but of course it is hard not to..  ESP when the diagnosis has to fit in a line or two.  As we all know from our path reports it is not so simple.

    And have2laugh, enjoy your little one!  My son is now twelve and the time goes way too fast!

  • rettemich
    rettemich Member Posts: 369
    edited March 2014

    As someone who has gone through Meanopause as I like to call it. It was Horrible for me, wouldn't put me on HT and nothing would help.

    Just the last few months I actually started to become "normal" again. I can't imagine going through that again, no, I can't go through that again. So I understand completely. I am on the bubble about it to.

    I don't even know how to post my Dx and stuff LOL so lame. 

    I know it's DCIS 6cm Stage 0 Grade 2 with lumpectomy scheduled for 3-25. 

    How do I get the stats on what my recurrence risks are? I am still really new and still very confused.

  • percy4
    percy4 Member Posts: 477
    edited March 2014

    Just an update.  First of all, that you all for your responses.  Right now, 10 days out from finishing radiation, and done with my treatment, I am starting to get that this is over.  The surgery went well, the rads went well.  I've looked into it carefully, and with my low recurrence chance, I'm good with not taking the AI.  Will be, as I said, exercising strongly from now on to cut recurrence chance, as much as that can  That is my personal decision (everyone's is different; each woman has to decide for herself), based on what the docs have told me, and also the support and info (Beesie and ballet, among many others, have given me some really great factual advice, not to do it or not, but just about what to think of in deciding) I've gotten here.  I'm sure future screenings will feel scary when I'm about to have them, but everybody has something in life.  I'm just now getting that, to this point, my episode with BC is over, and it's time to move on with my life.  I feel GOOD!

  • Rubiayat
    Rubiayat Member Posts: 144
    edited March 2014

    I'm glad to hear you are feeling good percy and ready to move on!

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